血清脂联素、胱抑素C与糖尿病肢体动脉闭塞症的糖脂代谢的关系  

The relationship between serum adiponectin, cystatin C and glucolipid metabolism in diabetic limb artery occlusion

作　　者：徐丽英 方豫东 曹烨民 赵满忱 周敏杰 XU Liying;FANG Yudong;CAO Yemin;ZHAO Manchen;ZHOU Minjie(Department of Vascular Branch,Shanghai TCM-Integrated Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai200082,China)

机构地区：[1]上海中医药大学附属上海市中西医结合医院脉管科

出　　处：《中国医药导报》2020年第1期98-101,共4页China Medical Herald

基　　金：上海市科学技术委员会科研计划项目（17401933200）

摘　　要：目的探讨血清脂联素(APN)、胱抑素C(CysC)等与糖尿病肢体动脉闭塞症(DLAO)的糖脂代谢的相关性。方法选取2017年7月~2018年12月上海中医药大学附属上海市中西医结合医院收治的DLAO一期或二期患者77例以及糖尿病(DM)患者76例为研究对象,分别命名为DLAO组和DM组。所有对象检测体重指数(BMI)、腰臀比(WHR)及血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(Apo-A1)、载脂蛋白B(Apo-B)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、CysC、APN水平。对DLAO患者进行WHR、APN、CysC、Apo-A1为自变量的logistic逐步回归分析。对血清APN与BMI、WHR、糖尿病病程、TC、TG、HbA1c、CysC进行Pearson相关分析。结果 DLAO组的WHR、血清CysC水平明显高于DM组;DLAO组的血清APN、Apo-A1明显低于DM组,差异均有统计学意义(均P <0.05)。两组患者FBG、HbA1c、BMI、TC、TG、HDL-C、LDL-C、Apo-B比较,差异均无统计学意义(均P> 0.05)。logistic逐步回归分析发现高水平的血清APN为DLAO独立保护性因素,高水平的血清CysC为DLAO独立危险因素(P <0.05)。Pearson相关分析显示,血清APN水平与WHR、糖尿病病程、血清CysC水平呈负相关(r <0,P <0.05),与BMI、TC、TG、HbA1c无相关性(P> 0.05)。结论血清APN、CysC对DLAO形成、发展中的糖脂代谢有一定的影响。Objective To investigate the correlation between serum adiponectin(APN) and cystatin C(CysC) on glucolipid metabolism in diabetic limb artery occlusion(DLAO). Methods From July 2017 to December 2018, 77 patients with the first stage or the second stage DLAO and 76 patients with diabetes mellitus(DM) admitted to Shanghai TCMIntegrated Hospital, Shanghai University of Traditional Chinese Medicine were selected as the study objects, named as DLAO group and DM group respectively. Body mass index(BMI), waist hip ratio(WHR) and serum total cholesterol(TC), triacylglycerol(TG), high-density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C),apolipoprotein A1(Apo-A1), apolipoprotein B(Apo-B), fasting blood glucose(FBG), glycosylated hemoglobin(HbA1 c),CysC, APN levels were measured for all subjects. Logistic stepwise regression analysis with WHR, APN, CysC and Apo-A1 as independent variables was conducted for DLAO patients. Pearson correlation analysis was conducted between serum APN and BMI, WHR, course of diabetes, TC, TG, HbA1 c, CysC. Results The levels of WHR and serum CysC in the DLAO group were significantly higher than those in the DM group. Serum APN and Apo-A1 in the DLAO group were significantly lower than those in the DM group, with statistically significant differences(all P < 0.05). FBG,HbA1 c, BMI, TC, TG, HDL-C, LDL-C and Apo-B of parents in the two groups showed no statistically significant differences(all P > 0.05). Logistic stepwise regression analysis found that high serum APN was the independence protective factor for DLAO, while high serum CysC was the independence risk factor for DLAO(P < 0.05). Pearson correlation analysis showed that serum APN level was negatively correlated with WHR, diabetes course, and serum CysC level(r <0, P < 0.05), but not with BMI, TC, TG, and HbA1 c(P > 0.05). Conclusion Serum APN and CysC have a certain effect on glucolipid metabolism during the formation and development of DLAO.

关 键 词：脂联素 胱抑素C 糖尿病肢体动脉闭塞症 糖脂代谢 

分 类 号：R587[医药卫生—内分泌]